Questions and Answers
What was the term used in the early 1900s to describe children exhibiting behaviors such as impulsivity and hyperactivity?
Which of the following symptoms is NOT associated with inattention in ADHD?
Which of the following statements accurately describes the prevalence of ADHD?
What is a common associated condition for hyperactivity and impulsivity in children with ADHD?
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How does impulsivity in ADHD manifest in social settings?
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What is the risk of ADHD in first-degree relatives compared to the general population?
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Which brain region is primarily implicated in ADHD due to its use of dopamine?
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Which of the following is NOT considered a risk factor for developing ADHD?
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What polymorphism is associated with ADHD as suggested by several linkage studies?
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Which environmental factor is linked to a higher risk of developing ADHD?
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Which of the following describes the structural imaging findings commonly associated with ADHD?
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What course modifier may influence the development of conduct problems in children with ADHD?
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Which of the following symptoms is commonly observed in children with ADHD?
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Which neuroanatomical area is involved in encoding memory traces and is associated with ADHD?
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Study Notes
History of ADHD
- Early 1900s identified a “hyperactive syndrome” characterized by impulsive, disinhibited, and hyperactive behaviors in children, often linked to neurological damage.
- In the 1960s, the term “minimal brain damage” emerged for a varied group of children who exhibited poor coordination and learning disabilities without identifiable neurological disorders.
- Various hypotheses have been proposed for ADHD, including abnormal arousal and emotional modulation difficulties, evidenced by improved focus with stimulant medications.
- ADHD symptoms involve a persistent pattern of inattention and/or hyperactivity-impulsivity affecting functioning or development.
- Inattention includes behaviors such as task wandering, disorganization, and difficulty sustaining focus, unrelated to defiance or comprehension issues.
- Hyperactivity manifests as excessive motor activity inappropriate for the context, while impulsivity is seen in hasty actions with potential risks, like running into traffic or making rash decisions.
ADHD Subtypes
- Inattention associated with anxiety and depression (15% prevalence).
- Hyperactivity-impulsivity linked to oppositional defiant disorder and conduct disorder (5% prevalence).
- Combined type is the most common, accounting for 80%.
Prevalence of ADHD
- Most prevalent chronic behavioral disorder in children, affecting 3-5% globally.
- Approximately 2.5% of adults are diagnosed with ADHD.
- Higher prevalence in males, with ratios of 2:1 in children and 1.6:1 in adults.
- Increased likelihood of ADHD in parents and siblings—2 to 8 times greater than the general population.
Etiology
- No single cause of ADHD; symptoms occur both with and without identifiable risk factors.
- Correlation with other childhood conditions like motor dyspraxia, tics, and speech disorders.
- Overactive behavior often observed in children with a history of infections, head trauma, or extreme prematurity.
Neurobiologic Basis and Genetics
- Families of ADHD/CD children commonly show high rates of sociopathy and alcoholism.
- Elevated attention deficit symptom ratings in parents of ADHD children.
- First-degree relatives have a 4.6- to 7.6-fold increased risk of ADHD.
- Genetic factors indicate high heritability, likely involving multiple genes including polymorphisms in DRD4 and DAT1.
- The prefrontal cortex, involved in attention and decision-making, is highlighted in ADHD neurobiology.
- Abnormalities found include smaller right frontal lobe structures, reduced corpus callosum size, and diminished overall cerebral volume.
Risk Factors
- Temperamental factors: Reduced behavioral inhibition, negative emotionality, and elevated novelty seeking linked with ADHD behaviors.
- Environmental influences: Low birth weight, prenatal exposure to tobacco, child maltreatment, neurotoxin exposure, and in utero alcohol exposure.
- Family dynamics during early childhood could modify the course of ADHD or lead to secondary conduct issues.
Clinical Features
- Signs typically begin in early childhood, leading to challenges in attention, hyperactivity, and impulsivity impacting various aspects of life.
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Description
Test your knowledge on the history and theories surrounding Attention-Deficit Hyperactivity Disorder (ADHD). Explore how perceptions of ADHD have evolved from the early 1900s to the present. This quiz covers key milestones and hypotheses related to ADHD symptoms.
